Suprasystolic measurement in a fast blood-pressure cycle

ABSTRACT

Disclosed herein is a system for monitoring a patient that includes a cuff configured to inflate to at least partially occlude an artery of the patient and a cuff controller configured to inflate the cuff during a dynamic phase and generally maintain inflation of the cuff at about a target pressure during a static phase. The system also includes a sensor configured to receive a signal associated with the at least partially occluded artery and generate an output signal based on the received signal, and a cuff control module configured to determine the target pressure during the dynamic phase and based on the output signal, and control the cuff controller during the dynamic phase and the static phase.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of and claims priority to U.S.Non-Provisional application Ser. No. 12/650,984, filed on Dec. 31, 2009,and titled “Suprasystolic Measurement in a Fast Blood-Pressure Cycle”,which is hereby incorporated by reference in its entirety.

TECHNICAL FIELD

This application is directed to systems and methods for monitoring apatient, and in particular, to a suprasystolic measurement in a fastblood-pressure cycle.

BACKGROUND

Traditional non-invasive blood pressure monitoring devices operate byinflating a cuff to a pressure well above a patient's systolic bloodpressure. Because the systolic pressure is usually not know prior toinflation, the cuff must be inflated to such a high pressure to ensurethat the patient's arterial blood flow is completely occluded. Once wellabove systole, the cuff is deflated and the systolic and diastolicpressures are calculated based on signals provided during cuffdeflation.

Some methods have been developed to estimate blood pressures during cuffinflation. These methods, however, are generally inaccurate and/or slow.Consequently, such methods cannot provide a commercially usefuldetermination of systolic pressure that must meet certain regulatorystandards.

More recently, a suprasystolic measurement technique has been developed,as described by U.S. Pat. No. 6,994,675. This technique includesinflating a cuff to a “suprasystolic pressure,” about 10-40 mmHg above apatient's systolic pressure. Suprasystolic pressure can be maintainedwhile signals from the occluded artery are collected. These signals areprocessed to determine a number of hemodynamic parameters, such as, forexample, aortic compliance.

Current suprasystolic methods require determining a patient's systolicblood pressure prior to inflating the cuff because the suprasystolicpressure is directly proportional to the systolic pressure. As describedabove, current methods for accurately determining systolic pressure relyon inflating and then deflating a cuff. Thereafter, the cuff isre-inflated to a suprasystolic pressure (i.e., about 10-40 mmHg abovesystole). Such repeated inflation and deflation of the cuff takesadditional time and exposes the patient to the additional discomfort.

The present disclosure is directed to systems and methods for providinga suprasystolic measurement in less time and with less patientdiscomfort than prior techniques. In one exemplary embodiment, apatient's systolic pressure can be determined during cuff inflation.Following inflation, the cuff can be maintained at a suprasystolicpressure determined by the systolic pressure. During this suprasystolicphase, signals from the patient can be measured and analyzed todetermine one or more hemodynamic parameters. Thus, data obtained duringan inflationary, or dynamic phase, of a pressure cycle may be used inreal time to determine if and how a suprasystolic measurement should beconducted. Combining a systolic pressure determination and suprasystolicmeasurement into a single pressure cycle can reduce cycle time andminimize patient discomfort.

SUMMARY

A first aspect of the present disclosure includes a system formonitoring a patient having a cuff configured to inflate to at leastpartially occlude an artery of the patient and a cuff controllerconfigured to inflate the cuff and generally maintain inflation of thecuff at about a target pressure. The system also includes a sensorconfigured to receive a signal associated with the at least partiallyoccluded artery and generate an output signal based on the receivedsignal, and a cuff control module configured to determine the targetpressure during the dynamic phase and based on the output signal, andcontrol the cuff controller during the dynamic phase and the staticphase.

A second aspect of the present disclosure includes a method ofdetermining a hemodynamic parameter of a patient that includes providinga cuff configured to at least partially occlude a vessel of the patient.The method includes inflating the cuff to a target pressure during adynamic phase, wherein the target pressure can be determined during thedynamic phase, maintaining the inflatable cuff at about the targetpressure during a static phase, and determining the hemodynamicparameter during the static phase.

A third aspect of the present disclosure includes a processor configuredto transmit a first signal to inflate a cuff to at least partiallyocclude an artery of a patient and receive a signal from the cuffrepresentative of vibrations from the at least partially occludedartery. The processor can further determine a target pressure duringcuff inflation based on the received signal, and transmit a secondsignal to generally maintain cuff inflation at about the targetpressure.

Additional objects and advantages of the present disclosure will be setforth in part in the description which follows, and in part will beobvious from the description, or may be learned by practice of thepresent disclosure. The objects and advantages of the present disclosurewill be realized and attained by means of the elements and combinationsparticularly pointed out in the appended claims.

It is to be understood that both the foregoing general description andthe following detailed description are exemplary and explanatory onlyand are not restrictive of the present disclosure, as claimed.

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate several embodiments of thepresent disclosure and together with the description, serve to explainthe principles of the present disclosure.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a monitoring system, according to an exemplaryembodiment.

FIG. 2 illustrates a pressure pulse applied by the monitoring system,according to an exemplary embodiment.

FIG. 3 illustrates a first flow chart, according to an exemplaryembodiment.

FIG. 4 illustrates a second flow chart, according to another exemplaryembodiment.

DETAILED DESCRIPTION

Disclosed herein are patient monitoring systems and methods of usingsuch systems. In particular, the present disclosure provides asuprasystolic measurement in a fast blood-pressure cycle. Bothblood-pressure determination and suprasystolic measurement are generallycompleted in less time than a typical blood pressure assessment alone,such as, for example, about 25 seconds. The time is reduced in partbecause cuff re-inflation can be avoided.

The present disclosure also permits the use of real time data collectedduring inflation in a subsequent suprasystolic measurement. For example,an accurate suprasystolic pressure can be based on a systolic pressuredetermined during inflation. Further, if a suprasystolic measurementshould occur, the duration of a suprasystolic measurement, or what sortof signal analysis should be performed during suprasystolic measurementcan be determined during inflation.

In some embodiments, the combined blood-pressure determination andsuprasystolic measurement can provide dynamic information to a decisiontree or algorithm to determine a particular hemodynamic parameter. Forexample, a suprasystolic measurement might be conducted on patientshaving certain physiological indicators, such as, weight, heart rate, orblood pressure. A patient's physiological indicators may be determinedduring inflation. If one or more of these indicators fails to meetcertain criteria, the suprasystolic measurement could be cancelled andthe patient notified. Thus, various indicators could be tested duringinflation to ensure suitable suprasystolic measurement.

In yet other embodiments, the present system can permit rapid analysisof hemodynamic data gathered from unloaded, partially loaded, or fullyloaded vessels. Before inflation, the patient's vessels are unloaded andblood flow is not restricted. During inflation, termed a “dynamicphase,” the patient's vessels are progressively loaded, reducing bloodflow. At suprasystolic pressure, the patient's vessels are completelyloaded or occluded, termed a “static phase.” Data gathered during thesedifferent conditions may be compared and contrasted to determine one ormore hemodynamic parameters. For example, a beat-to-beat time during thedynamic phase, when the vessel is partially occluded, may be comparedwith a beat-to-beat time during the static phase, when the vessel iscompletely occluded. Such data comparison can provide an indication ofirregular heart beat timing. Two or more separate conditions could alsobe used to attenuate signal noise using various de-noising algorithms.

FIG. 1 illustrates a system 10, according to an exemplary embodiment ofthe present disclosure. System 10 can be configured to monitor apatient, and in some embodiments, to determine a hemodynamic parameterof the patient.

System 10 can include a cuff 12 configured to at least to partiallyocclude the movement of blood through a vessel of patient 14. In someembodiments, cuff 12 can be configured to completed occlude an artery ofpatient 14. Although shown in FIG. 1 surrounding the upper arm ofpatient 14, cuff 12 may be adapted for placement on any suitable part ofpatient 14, including, for example, a wrist, a finger, an upper thigh,or an ankle. In addition, one or more cuffs 12 could be placed atdifferent locations about patient 14 for use with system 10.

Cuff 12 can include an inflatable device, wherein the pressure or volumewithin cuff 12 may be controlled by a cuff controller 16 operablyassociated with cuff 12. Cuff controller 16 can include a pump orsimilar device to inflate cuff 12. For example, cuff controller 16 couldsupply cuff 12 with a fluid to increase the pressure or volume of cuff12. In other embodiments, cuff controller 16 could include mechanical,electrical, or chemical devices configured to control vessel occlusionof patient 14 via cuff 12.

In some embodiments, cuff controller 16 can generally maintain cuff 12at about a target pressure. For example, once a target pressure has beendetermined, as explained in detail below, cuff controller 16 couldcontrol cuff 12 to provide patient 14 with a generally constantpressure. While the present disclosure refers to a target pressure, itshould be understood that the actual pressure applied by cuff 12 mayvary. As such, the pressure applied to patient 14 may generally remainwithin appropriate limits, such as, for example, with 2%, 5%, 10%, or20% of the target pressure.

System 10 can further include a sensor 18 configured to receive a signalassociated with patient 14. In some embodiments, sensor 18 can beconfigured to receive a signal associated with an at least partiallyoccluded vessel of patient 14. Such an input signal can arise from bloodmovement through a partially occluded vessel or from a signal associatedwith an occluded blood vessel. Sensor 18 could sample multiple times atvarious intervals. In yet other embodiments, sensor 18 could provide anindication of blood vessel movement, such as, for example, oscillationsarising from vascular expansion or contraction. For example, sensor 18could be configured to detect a pressure or volume of cuff 12 that mayvary periodically with the cyclic expansion and contraction of an arteryof patient 14. In particular, sensor 18 could determine a blood pressureor other hemodynamic parameter associated with patient 14—using anoscillometric method.

In some embodiments, sensor 18 could detect a volume or a pressureassociated with cuff 12. For example, sensor 18 could include a pressuresensor and may be located within or about cuff 12. System 10 couldfurther operate with a plurality of sensors 18, and may include ahigh-resolution sensor or pneumatic sensor designed to operate inconjunction with cuff 12.

Sensor 18 can further be configured to generate an output signal. Theoutput signal may be generated based on an input signal received frompatient 14. In one aspect, the output signal can include arepresentation of an input signal associated with cuff 12 and/or patient14.

Cuff 12, cuff controller 16, and sensor 18 may be operably associatedwith a cuff control module 20. Specifically, cuff control module 20could include one or more processors configured to control one or moreoperations of cuff 12, cuff controller 16, or sensor 18. For example,cuff control module 20 can control inflation of cuff 12 via control ofcuff controller 16.

In some embodiments, cuff control module 20 can calculate a targetpressure. This calculation may be based on an output signal from sensor18, as described above. Cuff control module 20 may also controlinflation of cuff 12, inflation of cuff 12 to the target pressure, orgenerally maintaining inflation of cuff 12 at about the target pressure.

In operation, cuff control module 20 could calculate a target pressureduring inflation of cuff 12. Such a calculation could take less thanabout 15 seconds. Cuff control module 20 could then generally maintaincuff 12 at about the target pressure for a defined time period, such as,for example, less than about 10 seconds. In other embodiments, thetarget pressure could be generally maintained for a defined number ofcardiac cycles, such as, for example, six, eight, or ten cycles. Unlikecurrent suprasystolic techniques, such cardiac cycle data may beavailable upon reaching the target pressure. This availability canreduce the need to ignore or discount one or more of the first severalcardiac cycles from any suprasystolic measurement. Cuff compressionusing current techniques can cause conscious or unconscious musclemovement, affecting signals obtained during the first few beats at asuprasystolic pressure. Such data may be unsuitable for parameterdetermination, thereby prolonging the static phase. A more gradualcompression of a patient's limb or arteries up to a suprasystolicpressure can reduce or eliminate the effects of these unwantedmovements.

As shown in FIG. 1, system 10 can optionally include a signal analysismodule 22, a communication module 24, or an accelerometer 26. Thesecomponents may operate with one or more of the components of system 10as described above.

Signal analysis module 22 may be configured to analyze one or moresignals using one or more processors. Such analysis may be based on theoutput signal of sensor 18. For example, signal analysis module 22 caninclude one or more filters configured to filter a signal associatedwith sensor 18 or cuff control module 20. Such filters can includeband-pass, high-pass, or low-pass filters.

In some embodiments, signal analysis module 22 may determine ahemodynamic parameter. A hemodynamic parameter can include an indicationof cardiac or vascular health, such as, for example, an indication ofcardiac, circulatory, or vascular functionality. Specifically, ahemodynamic parameter can include a heart rate, a blood pressure, avessel compliance, an aortic index, an augmentation index, reflectedwave ratio, or an indication of treatment. Blood pressure can includesystolic, diastolic, or mean atrial pressure. An indication of treatmentcan include a parameter reflecting the affect of a drug treatment, orone or more treatments of a disease state.

In some embodiments, a hemodynamic parameter can be determined based ona suprasystolic measurement. In other embodiments, a hemodynamicparameter can be determined based on a first set of data obtained duringinflation of cuff 12 and a second set of data obtained during generalmaintenance of cuff 12 at about the target pressure, as explained belowin detail. The first or second sets of data can include various dataassociated with a signal waveform associated with patient 14 and/or cuff12, and may include amplitude, frequency, morphology, feature, ormathematically derived data. Data can be derived from a derivative,integration, or frequency analysis, such as, for example, a fast-Fouriertransform. Data may also be derived from various algorithms, includingcurve fitting, neural network, filtering, smoothing, or data processing.

System 10 can further include an accelerometer 26 to detect movement.Accelerometer 26 can be configured to detect movement in one, two, orthree dimensions. For example, accelerometer 26 could be used to detectmovement of patient 14 or movement of the arm of patient 14.

A signal arising from accelerometer 26 could be used to provideadditional information to another module. For example, if movement ofpatient 14 is sufficient to interfere with sensor 18, a signal fromaccelerometer 26 may be transmitted to cuff control module 20 to haltthe pressure cycle. In-addition, a signal from accelerometer 26 may betransmitted to signal analysis module 22 to cancel or reset acalculation. Data obtained from sensor 18 could be combined with datafrom accelerometer 26 to determine if an irregular signal may be causedby a motion artifact. Various data from accelerometer 26 may beprocessed to provide additional data to determine one or morehemodynamic parameters.

System 10 can further include a communication module 24 configured toprovide communication to patient 14 or one or more operators. Forexample, communication module 24 could include a display configured todisplay one or more hemodynamic parameters. In other embodiments,communication module could include a transmitter configured to transmitdata to a remote location. Communication module 24 may further includeaudio output to communicate with patient 14 and/or an operator of system10.

In addition to the components outlined above, system 10 may includevarious other components as required, such as, for example, a memory, apower source, and a user input. One or more components described hereinmay be combined or may be separate and operate with wireless or wiredcommunication links. Moreover, the various components of system 10 couldbe integrated into a single processing unit or may operate as separateprocessors. In operation, one or more processors can be configured tooperate in conjunction with one or more software programs to provide thefunctionality of system 10.

FIG. 2 shows a cuff pressure waveform 28 as applied to a patient over aperiod of time, according to an exemplary embodiment. For example,waveform 28 may be applied to patient 14 using system 10 as indicated inFIG. 1. In some embodiments, waveform 28 can include a dynamic phase 30and a static phase 32.

Dynamic phase 30 can include a generally increasing pressure. Forexample, as indicated in FIG. 2, dynamic phase 30 can include acontinuously increasing linear pressure curve. In other embodiments,dynamic phase 30 can include a step wise pressure increase, a curvedpressure increase, an exponential pressure increase, a gradual, or arapid pressure increase.

During dynamic phase 30, one or more sets of data may be obtained usingone or more sensors. Such data may be analyzed, as described in detailbelow, to determine a target pressure 34. Target pressure 34 can begreater than systolic pressure or about equal to systolic pressure. Insome embodiments, target pressure 34 can be about equal to asuprasystolic pressure.

Static phase 32 can include generally maintaining a cuff pressure atabout target pressure 34. In operation, a target pressure can bedetermined during dynamic phase 30 and applied during static phase 32.Target pressure 34 can include a generally constant pressure. In someembodiments, target pressure 34 can fluctuate within a range of values.For example, target pressure 34 can include values within about ±2%,±5%, ±10%, or ±20%.

In order to reduce patient discomfort, the duration of dynamic phase 30and static phase 32 should be less than about 60 seconds. In someembodiments, the duration of phases 30, 32 can be less than about 45seconds. In some embodiments, the duration of phases—; ˜3.0, 32 can beless than about 30 seconds. In particular, the duration of dynamic phase30 can be less than about 15 seconds and the duration of static phase 32can be less than about 10 seconds. Although FIG. 2 shows dynamic phase20 and static phase 32 juxtaposed, in some embodiments these phases maybe separated by one or more other phase of differing cuff pressureand/or duration.

FIGS. 3 and 4 illustrate flow charts of two exemplary embodimentsaccording to the present disclosure. As described above with regard toFIG. 1, various modules can include one or more hardware components andone or more software components that operate to control an operation ofsystem 10. Each step described below can be understood as correspondingto one or more computational instructions. These computationalinstructions can operate based on hardware and/or software components ofsystem 10, and may operate on one or more processors.

FIG. 3 includes a process 100 according to an exemplary embodiment ofthe present disclosure. Step 110, labeled “Start,” may include one ofmore steps required to initiate an operation of system 10. For example,system 10 may be turned on, a calibration protocol may be started, acuff may be placed about a patient's arm, an operator may enterinformation to identify a patient, or information could be extractedfrom a database. Further, various components of system 10 may becalibrated or tested to ensure proper functioning. These operationscould include a check of cuff integrity, if sufficient power isavailable, a calibration of one or more sensors, or confirmation ofproper processor functioning. Also, other information may be enteredinto system 10, such as a patient identification, weight, gender,height, or other suitable data.

After system 10 has completed start 110, cuff 12 may be inflated (Step112). This step may be considered the start of dynamic phase 30. In someembodiments, Step 112 could be initiated as part of Step 110.

As described above with regard to FIG. 1, cuff controller 16 may operateto inflate cuff 12. During inflation, sensor 18 may detect one or moresignals. These signals may be analyzed by cuff control module 20 todetermine if sufficient information has been obtained (Step 114).Sufficient information can refer to providing one or more algorithmswith information sufficient to determine when cuff inflation should beterminated. For example, an algorithm could determine a target pressurefor cuff inflation. In other embodiments, an algorithm could determine atime to stop cuff inflation.

In one embodiment, an algorithm may use oscillometric pulse dataobtained during dynamic phase 30. The data may be analyzed in real timeuntil such a point that an algorithm deems the data sufficient for areading determination. Such data can relate to the maturity of the pulseenvelope or the amount of envelope found during inflation. The collectedpulse data can be filtered and/or conditioned. In other embodiments, amodel curve can be fit to the data. In yet other embodiments, data canbe submitted to a trained network of mathematical routines. Suchanalysis can be used to determine a systolic pressure or a diastolicpressure.

For example, the SureBP algorithm could be used to determine a systolicpressure. Such an algorithm is described in “Clinical evaluation of theWelch Allyn SureBP algorithm for automated blood pressure measurement,”by Bruce Alpert, which is hereby incorporated by reference in itsentirety. Such an algorithm can provide an accurate measure of systolicpressure during inflation, whereby the mean error is less than about 1mmHg and the standard deviation of the mean error is less than about ±7mmHg. In other embodiments, such an algorithm could provide a mean errorof less than about 5 mmHg and a standard deviation of less than about ±5mmHg.

If an algorithm determines that sufficient information has not yet beenobtained, cuff inflation (Step 112) can continue until sufficientinformation has been obtained. One or more safety algorithms could alsobe used to limit cuff inflation to a maximum pressure. For example,process 100 may terminate if cuff pressure reaches about 200 mmHg.

After sufficient information has been obtained for an algorithm todetermine a suitable stopping point for cuff inflation, a targetpressure may be determined (Step 116). In some embodiments, the targetpressure may include determining a systolic pressure. A suprasystolicpressure may then be determined based on the systolic pressure. Forexample, a suprasystolic pressure may be determined by adding about10-40 mmHg to the value of the systolic pressure. The value of thetarget pressure may be determined based on the suprasystolic pressure.In some embodiments, the target pressure may be set to the same value asthe suprasystolic pressure.

Once a target pressure has been determined (Step 116), cuff inflationmay be continued to the target pressure (Step 118). Once cuff inflationreaches the target pressure, dynamic phase 30 can be considered completeand static phase 32 may begin. During static phase 32, cuff pressure canbe maintained generally about the target pressure (Step 120). Aspreviously described, such maintenance can include minor fluctuationsabout the target pressure.

During static phase 32, one or more hemodynamic parameters may bedetermined (Step 122). The hemodynamic parameters may be determinedusing suprasystolic analysis methods. For example, as described in U.S.Pat. No. 6,994,675 to Sharrock, large arterial vascular compliance maybe determined using one of more signals obtained during static phase 32(i.e. a suprasystolic phase). While Sharrock describes the use of awideband acoustic transducer, signals from other pressure transducerscan be used to analyze temporal or amplitude variations of signalsobtained during the suprasystolic phase. U.S. Patent ApplicationPublication No. 2006/0224070 to Sharrock et al. describes usingsuprasystolic measurements to determine Augmentation index, cardiacperformance and cardiac stroke volume. U.S. Patent ApplicationPublication No. 200/0012411 to Lowe et al. describes using oscillometrictechniques to analysis suprasystolic signals. Each of these referencesis hereby incorporated by reference in their entirety.

Following Step 122, process 100 may end (Step 124). Termination ofprocess 100 can include gradual or rapid cuff deflation, display of oneor more hemodynamic parameters, or power shut-down.

FIG. 4 includes a process 200 according to another exemplary embodimentof the present disclosure. Process 200 can include various steps similarto the steps described above for process 100. For example, Step 210,labeled “Start,” may include one of more steps required to initiate anoperation of system 10, as previously described for Step 110. Similarly,Steps 212, 214, 216, and 218 can occur during dynamic phase 30, asdescribed above for Steps 112, 114, 116, and 118, respectively. Further,Steps 220 and 224 can occur during static phase 32, as described abovefor Steps 120 and 124, respectively.

Process 200 can include one or more additional steps during dynamicphase 30. In some embodiments, a first set of data can be obtainedduring dynamic phase 30 (Step 215). Such data can include informationobtained from an oscillometric pulse. In some embodiments, the source ofthe first set of data may be different to the source providing data todetermine the target pressure.

Process 200 can also include one or more additional steps during staticphase 32. In some embodiments, a second set of data can be obtainedduring static phase 32 (Step 221). As described above, first and secondsets of data can include any signal waveform data associated withpatient 14 and/or cuff 12, and may include amplitude, frequency,morphology, feature, or mathematically derived data.

Based on first and second data sets, a hemodynamic parameter can bedetermined (Step 222). First and second data sets can be obtained andcompared and contrasted to determine one or more parameters. Forexample, a beat-to-beat time during dynamic phase 30 can be compared toa beat-to-beat time during static phase 32. Such a comparison can beused to check for irregular heart beat timing. Other parameters can bedetermined based on comparing unloaded (i.e. dynamic phase 30) data withloaded (i.e. static phase 32) data. These two separate sample conditionscan also be contrasted to determine one or more parameters using othermethods known in the art.

In addition, analysis techniques can be used to reduce signal noise.For, example, first and second data sets may be used to remove commonnoise associated with both sets of data. A cleaner signal may be used tomore accurately or precisely determine a hemodynamic parameter.

In other embodiments, one or more parameters determined during staticphase 32 could be used to confirm any determinations based on dataobtained during dynamic phase 30. For example, a second determination ofsystolic pressure could be made based on a second set of data obtainedduring static phase 32. The two values of systolic pressure could becompared to ensure that both are within acceptable limits to confirm theaccuracy of any calculated parameters. If outside acceptable limits,process 200 may be terminated (Step 224) and repeated if desired.

Other embodiments of the present disclosure will be apparent to thoseskilled in the art from consideration of the specification and practiceof the disclosure contained herein. It is intended that thespecification and examples be considered as exemplary only, with a truescope and spirit of the present disclosure being indicated by thefollowing claims.

What is claimed is:
 1. A method of manufacturing a measurement system,comprising: providing a cuff; providing a cuff controller to inflate thecuff to at least partially occlude an artery of a patient during asingle dynamic phase; configuring the cuff controller to maintaininflation of the cuff about a target pressure during a static phase,wherein the target pressure is a suprasystolic pressure; providing afirst sensor to acquire a signal associated with the at least partiallyoccluded artery; and providing a signal analysis module configured todetermine a parameter based on the signal from the first sensor, whereinthe parameter is determined based on a fist set of data obtained overmore than two cardiac cycles during the single dynamic phase and asecond set of data obtained during the static phase, the second set ofdata being obtained over a defined number of cardiac cycles immediatelyfollowing the beginning of the static phase.
 2. The method of claim 1,wherein the signal analysis module determines during inflation whether asuprasystolic measurement should be performed.
 3. The method of claim 2,wherein the determination of whether a suprasystolic measurement shouldbe performed is at least partially based on a physiological indicator.4. The method of claim 1, wherein the signal analysis module determinesirregular heart beat timing using the first and second sets of data. 5.The method of claim 4, wherein the first set of data includes a firstbeat-to-beat time and the second set of data includes a secondbeat-to-beat time.
 6. The method of claim 1, further comprisingproviding a second sensor.
 7. The method of claim 6, wherein anirregular signal is determined using data from the second sensor and thesignal, wherein the second sensor is an accelerometer.
 8. The method ofclaim 1, further comprises providing a filter to filter the signal. 9.The method of claim 1, wherein the parameter is used to provide anindication of at least one of cardiac health, vascular health, and drugtreatment.
 10. A method of determining a parameter of a patient,comprising: inflating a cuff to at least partially occlude an artery ofthe patient during a single dynamic phase; substantially maintaininginflation of the cuff about a target pressure during a static phase,wherein the target pressure is a suprasystolic pressure; acquiring asignal associated with the at least partially occluded artery using afirst sensor; and determining both a systolic pressure and the targetpressure during the single dynamic phase and based on the signal, andcontrol the cuff controller during the dynamic phase and the staticphase; and determining a parameter, using a signal analysis module,based on the signal, wherein the parameter is determined based on a fistset of data obtained over more than two cardiac cycles during the singledynamic phase and a second set of data obtained during the static phase,the second set of data being obtained over a defined number of cardiaccycles immediately following the beginning of the static phase.
 11. Themethod of claim 10, further comprising determining during inflationusing the signal analysis module whether a suprasystolic measurementshould be performed.
 12. The method of claim 11, wherein thedetermination of whether a suprasystolic measurement should be performedis at least partially based on a physiological indicator.
 13. The methodof claim 10, further comprising determination of irregular heart beattiming using the first and second sets of data.
 14. The method of claim13, wherein the first set of data includes a first beat-to-beat time andthe second set of data includes a second beat-to-beat time.
 15. Themethod of claim 10, further comprising maintaining the target pressurefor less than about 10 seconds.
 16. The method of claim 10, furthercomprising determining an irregular signal using the signal analysismodule.
 17. The method of claim 16, wherein the irregular signal isdetermined using second sensor data, from a second sensor, and thesignal.
 18. The method of claim 10, wherein the signal analysis moduleuses a filter to filter the output signal from the first sensor.
 19. Themethod of claim 10, wherein the parameter is used to provide anindication of at least one of cardiac health, vascular health, and drugtreatment.
 20. A system for monitoring a patient, comprising: a cuffconfigured to inflate to at least partially occlude an artery of thepatient; a cuff controller configured to inflate the cuff to a targetpressure during a dynamic phase and, following the dynamic phase,generally maintain inflation of the cuff at about the target pressureduring a static phase; a sensor configured to receive a signalassociated with the at least partially occluded artery; a cuff controlmodule configured to determine both a systolic pressure and the targetpressure in real time during the dynamic phase and based on the outputsignal, and control the cuff controller during the dynamic phase and thestatic phase; and a signal analysis module configured to determine anindication for the patient based on the signal, wherein the indicationis determined based on a first set of data obtained during the dynamicphase and a second set of data obtained during the static phase.
 21. Thesystem of claim 20, wherein the indication is of at least one of cardiachealth, vascular health, and drug treatment.